辅助生殖技术助孕后三胎合并双胎反向动脉灌注序列征一例并文献复习  

Triplet Pregnancy Complicated by Twin Reversed Arterial Perfusion Sequence after Assisted Reproductive Technology:A Case Report and Literature Review

作　　者：李婷婷 谭小方[1] 施蔚虹[1] LI Ting-ting;TAN Xiao-fang;SHI Wei-hong(Reproductive Medicine Center,Affiliated Maternity and Child Health Care Hospital of Nantong University,Nantong 226007,Jiangsu Province,China)

机构地区：[1]南通大学附属南通妇幼保健院生殖医学中心,226007

出　　处：《国际生殖健康／计划生育杂志》2024年第1期24-27,共4页Journal of International Reproductive Health/Family Planning

基　　金：南通大学临床医学专项青年项目(2022LQ007)。

摘　　要：双胎反向动脉灌注序列征(twin reversed arterial perfusion sequence,TRAPS)是单绒毛膜双胎妊娠(单绒双胎)的严重并发症,较为罕见,是由于双胎妊娠中胎儿胎盘间血管异常吻合所致,特征表现为其中一胎心脏缺如或心脏结构失去正常发育形态。报告南通大学附属南通妇幼保健院收治的1例发生于辅助生殖技术助孕后三胎妊娠中的TRAPS。患者移植2枚卵裂期冻融胚胎,其中1枚胚胎在分裂过程中发育为单绒双胎。患者孕8+5周早孕B超及时诊断单绒双胎为TRAPS,但因个人因素未行干预,单绒双胎TRAPS之泵血胎儿死亡。另一单胎发育正常至足月分娩。TRAPS如果需要治疗,射频消融术通常是阻断无心胎儿血流供应技术的首选方法,但干预的最佳时机仍存在争议。Twin reversed arterial perfusion sequence(TRAPS)is a rare and severe complication of monochorionic twin pregnancies,due to abnormal placental-fetal vascular anastomosis,which is characterized by absence of heart or loss of normal cardiac structure in one twin.We reported a case of triplet pregnancy complicated by TRAPS after assisted reproductive technology.Two cleavage-stage frozen embryos were transferred,one of which developed into monochorionic twin pregnology.The TRAPS was diagnosed by ultrasound at 8+5 weeks.However,due to personal factors,the patient did not intervene in a timely manner and the pump twin died.Another single fetus developed normally until full term delivery.If the treatment is needed,as for the technique of choice to interrupt the vascular supply to the acardiac twin,the radiofrequency ablation of the intrafetal vessel is usually the preferred approach.However,the best timing of intervention is still debated.

关 键 词：生殖技术 辅助 双胎 单卵 妊娠 三胎 双胎反向动脉灌注序列征 诊断 治疗 

分 类 号：R714.23[医药卫生—妇产科学]